Get up when the alarm goes off, shower, and put on fresh scrubs. Relish the moment, this is the cleanest you are ever going to get today. Eat heartily because nursing is not only for the strong of will but the strong of gut as well.

Feel the odd urge to want to get to work a few minutes earlier. Know that being early will not be acknowledged on your pay slip but will shape the quality of your work. Get to work early, anyway. Accept the endorsements of your coworkers with a smile. Their shift has just ended, do not expect them to be clean, thorough or in good spirits. Smile, anyway. Be patient and give them time and your undivided attention.

Don’t wish for an easy shift. This will lead to disappointment and frustration when the inevitable walks in, which could be anything from the common flu to a multiple gunshot wound. Wish for fortitude and being able to eat on time instead. Check and prepare your equipment and medication conscientiously. This will save you time, and a day’s worth of mental and emotional anguish. You are here to mitigate bodily disasters. There is no other way to go about it.

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Quickly assess patients as they come in. Use your intuition. You will become instinctively attuned to the workings of the human body when you keep an open and inquisitive mind. Pain matters. It tells you something is wrong. It gives us the chance to fix, transcend, and heal.

Physical pain is easy. You run diagnostics and give pain medication while figuring out what has gone awry. It’s the other kind that’s hard. It’s the widow weeping in the corner, the bruised child sitting still, and the father staring into space. There is no textbook manual on empathy. Be human, that is all they really need from you. Listen and always try to understand. The people we meet at work are in the middle of what could probably be one of the worse days of their lives. They will not be rational, polite or calculated. Organs fail, systems go haywire, bones break, and people hurt. Know that at any given moment it could have been one of your people lying on the stretcher. It could have been someone you love. It could have been you. Never look away. Keep your head above the water. Tread the fine line between the surreal and the random cruelty of life.

In a nutshell, the healthcare industry is institutionalized compassion. Healthcare workers are the determination of divine goodwill in a man’s world. There is bound to be friction. We operate within a framework and the bureaucracy of that framework. Wade through the turbulent currents of policy and practicality. Never forget your own voice, especially when you discuss issues with your coworkers and superiors. You are a nurse first and an employee second. Sometimes the two will be at odds with each other. Give the former a bigger voice. This is what the strength of will is for. There will be days when you will doubt yourself. This is fine. It means you still care enough to want to be better. The moment you stop wondering and wanting is what you should be afraid of. At its most basic, the greatest challenge of a registered nurse is to be charitable and selfless in a world that is not charitable and selfless by nature.

Strike the balance between precision and compassion. Insert IV lines and defibrillate. Don’t be afraid to pierce skin and draw blood. Keep your hands steady. Saving lives requires a measure of detachment from human sentimentality while sustaining the earnest belief that this person loves and is loved and that it is your job to keep that cycle running.

Most of the measures we take to save lives seem grisly and almost violent. Don’t flinch. Remind yourself every time that you are doing them kindness. You will get better at this as time goes by. There are some things you can only learn from repetition. The unpredictability and wanton disregard of change has never seemed so palpable as that in the small window of opportunity in a crisis. Time is critical. Life is fragile. People fall apart so easily. The body can stop trying in an instant. Hope for the best and prepare for the worst. Close curtains. Recognize your own powerlessness when the end comes. Sometimes, the best form of kindness we can give to another person is a dignified death. Remove tubes with care and wipe away body fluids. Dress open wounds. Cover the body with a sheet.

It is a curious position to find one’s self in: Close encounters of the wondrous and harrowing kind make us acutely aware of how terrible and extraordinary people can be, how terrible and extraordinary things can happen, and how terribly and extraordinarily we can do. Being within arm’s length of other people’s tragedies is a privilege reserved for the courageous few. In that singular moment we hold in our hands the power to save. Do the kind of work that will make you proud by day and sleep well at night.

Make your presence count. The only way to save a life is to go beyond your own. In saving others, we save ourselves.